Watson Goes to Work in the Hospital

Data deluge: Streams of medical data from babies in the ICU can provide early warning of an infection.

Designed to answer Jeopardy! questions, IBM’s Watson is of little use beyond the game show’s set. But some of the techniques that helped the computer defeat two human Jeopardy! champions in February are showing promise in a new context: the hospital. Researchers in Canada are using analytics like those that helped the computer decipher the language of clues to provide an early warning when babies in an intensive care unit acquire a hospital-borne infection.

As you would expect, babies in an ICU are surrounded by equipment that tracks their vital signs, but much of that data is wasted, says Carolyn McGregor, a researcher at the University of Ontario Institute of Technology. “They produce constant streams of data,” she says, “but that information is often distilled down to a [nurse’s] spot reading every 60 minutes, written on paper.”

McGregor leads a project that has developed software to ensure that no scrap of that data goes to waste. At the neonatal ICU of the Hospital for Sick Children in Toronto, that software, dubbed Artemis, collects data from eight infant beds. The system can monitor the baby’s electrocardiogram, heart rate, breathing rate, blood oxygen level, temperature, and blood pressure. It can also access data from medical records, such as the baby’s birth weight. McGregor and colleagues are developing algorithms that use those signals to spot signs of hospital-borne infection before doctors and nurses do.

Current practice used to diagnose infections in the ICU has a high false-positive rate, which means that many babies are misdiagnosed and receive drugs they don’t need, or occupy an ICU bed for longer than necessary. “Babies diagnosed with infection have, on average, a doubling of length of stay,” says McGregor. “We want to reduce that.”

The researchers have already shown that Artemis can use some of the same clinical observations that doctors use to diagnose babies. For example, the system can spot episodes of apnea (a pause in breathing), which is thought to increase in frequency when an infection sets in, says McGregor. Other research has shown that a variation in heart rate can warn of an infection 24 hours before most other symptoms occur. “We have proposed our own algorithm that uses those, and a wider range of data, to detect signs of infection,” says McGregor.

Two slightly different versions of that algorithm are being trialed in the ICU. The results are due to be published later this year. The software’s effectiveness will be judged by comparing its decisions and observations with those made by medical staff. Algorithms that attempt to learn new warning signs of infection are also being tested. “No one has had access to all this data before, so we can’t always refer to past research,” says McGregor.

Artemis is built on an analytics platform called InfoSphere Streams that, like Watson, emerged from IBM research into ways that software can make decisions on the spot using data arriving at a high speed from many different sources.

“The processing paradigms we had before just didn’t fit with the kind of streaming data we are dealing with,” says McGregor. Software has traditionally performed analysis by systematically scouring a fixed, well-organized store of data, like a person navigating the stacks of a library, she explains.